Making staff “bothered” about the four hour metric and recognising it was a “quality standard not a performance target” was the main driver behind a struggling hospital’s accident and emergency performance recovery, a senior trust chief has told HSJ.

East of England Ambulance Service Trust has been rated requires improvement by the Care Quality Commission, which raised concerns about a “lack of leadership”, “low staff morale”, and an “unsustainable” strategy in key areas.

A 91-year-old stroke patient who waited nearly 19 hours for an ambulance in the East of England was among 22 cases investigated by an external review which found no one died “as a direct consequence” of long delays, HSJ has learned.

Three clinical commissioning groups in Essex and Suffolk have set out plans to form a “single strategic commissioning body” across county boundaries as part of local plans to establish an integrated care system

The Suffolk and north east Essex sustainability and transformation plan footprint is searching for an independent chair with just days to go until the submission deadline for the high profile plans, HSJ has learned.

Colchester Hospital University Foundation Trust has been told by regulators if it does not form a “long term partnership” with Ipswich Hospital Trust it risks being put in the failure regime – a process which could result in its liquidation.